173593 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 00352777 Page 1 of 1
f ONE CIVIC SQUARE USA BLUE BOOK CHECK AMOUNT: $65.33
CARMEL, INDIANA 46032 Po Box 9004
6: GURNEE IL 60031 -9004 CHECK NUMBER: 173593
CHECK DATE: 6/10/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 818298 65.33 OTHER EXPENSES
y4
UISAAMBIveRooR INVOICE
TEL: (847) 689 -9781 818298 1 of 1
Remit t0: FAX: (847) 689 -3001
P.O. Box 9004 TOLL FREE: 1- 800 493 -9876
Gurnee, IL 60031 -9004 F.E.I.N.:36- 3645787 936803 05/18/09
BILL TO: SHIP TO:
936803 1
CARMEL UTILITIES CARMEL UTILITIES
760 3RD AVE SW STE 110 9609 HAZEL DELL PWKY
CARMEL, IN 46032 INDIANAPOLIS IN 46280
ATTN JEFF COOPER
CUSTOl1NER POp aHIP DATE' "g. SLP Ti MS ];TAX CODE'. W1H- "FREIGHT SHIP'VIA
ORDER No.
5/18/09 05/18/09 ALH NET 30 INEXEMPT 620205 01 PREPAID UPS
USA STOCK NO. DESCRIPTION, ORDERED SHIPP SACK
Ep. ORDER ,U /M PRICE PER EXENSfON
14217 Stream /Fog Nozzle 1 -1/2" NST 3 3 0 EA 18.50 EA 55.50
Polycarbonate RATED 100 PSI
THANK YOU for your business! DISCOUNT TOTAL.
1.5% MONTHLY FINANCE CHARGE
ON AMOUNTS 30 DAYS PAST DUE 55.50 .00 .00 .00 9.83 65.33
Discounts Apply to Merchandise Only
Should it become necessary to refer your unpaid balance to a collection agency, a collection fee, not to exceed 25% of the
balance referred, plus reasonable attorney's fees: and court costs when necessary, will be added to the balance due.
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates -of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
352777
USA BLUE BOOK Purchase Order No. 11
P.O. Box 9004 Terms
Gurnee, IL 60031 Due Date 6/1/2009
I nvoice I nvoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/1/2009 818298 $65.33
hereby certify that the attached invoice(s), or bill(s) is (are) true and
,orrect and I have audited same in accordance with IC 1 5- 11- 10 -1.6
/Y /I c �C-
Date Officer
VOUCHER 095743 WARRANT ALLOWED
352777 IN SUM OF
USA BLUE BOOK
P.O. Box 9004
Gurnee, IL 60031
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
818298 01- 7202 -05 $65.33
Voucher Total $65M
Cost distribution ledger classification if
claim paid under vehicle highway fund